الفهرس 
Anatomy and physiologyOnly 14 pages are availabe for public view
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Abstract
Strabismus means ocular misalignment or deviation of one eye relative to the visual axis of the other eye. It is a common problem that affects 3-5% of the population; making strabismus surgery the most commonly performed pediatric eye surgery.
Three problems associated with strabismus are of particular interest for the anesthesiologist: the possible increased risk of malignant hyperthermia, the high incidence of postoperative nausea and vomiting (PONV), and the likelihood of an Oculo-cardiac reflex (OCR).
Squint correction is achieved by lengthening, shortening or tightening (resection) or transposition of any of the four recti and two oblique extra-ocular muscles, or combinations of any of the above.
General anesthesia is the usual choice for strabismus surgery in children because of the need for a motionless operative field. Inhalational induction with sevoflurane or halothane is the most commonly used in younger patients. Older children may prefer IV induction. A laryngeal mask airway (LMA) is often appropriate.
To provide these patients with the benefits of regional anesthesia, there have been attempts to add local anesthetic techniques to general anesthesia. Peribulbar block in addition to general anesthesia has been shown to reduce OCR, provide good analgesia and to decrease the incidence of PONV.
Topical anesthetic DROPs have also been used to decrease the incidence and severity of OCR. This study was a prospective randomized double blind study which was designed to evaluate the effectiveness of either peribulbar block or LA DROPs combined with GA in the prevention of the OCR and immediate PONV and intra-operative stress response compared with a control group receiving general anesthesia alone.